Two Drugs for Heart Failure Show Mixed Results

One drug should be used more often and the other not at all, researchers report

By Steven Reinberg
HealthDay Reporter

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WEDNESDAY, May 21 (HealthDay News) -- Two new studies have produced mixed results for two different drugs that are often used to treat heart failure.

In the first study, researchers found limited benefit from a drug called valsartan (Diovan), which is used to lower systolic blood pressure. The second study found no benefit from the use of a drug known as nesiritide (Natrecor) for heart failure in an outpatient setting. Both reports are published in the May 21 issue of Circulation: Heart Failure.

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"When you get heart failure, which means that the heart's function is not normal, and the pumping function of the heart deteriorates, low blood pressure becomes a risk factor," said Dr. Inder S. Anand, from the cardiology department at the VA Medical Center in Minneapolis, and author of the first study.

All drugs used to treat heart failure are also drugs that are used to lower blood pressure, Anand said. "So when you treat a patient with heart failure, whose blood pressure is already low, you worry about the risk of lowering of blood pressure further," he said.

If the blood pressure is too low, patients can get symptoms of hypotension, which include dizziness, fainting and perhaps even falling, Anand explained. "Because of this, most physicians don't use these drugs at doses that are effective and don't increase the doses as they should," he said.

Anand's team looked at the effects of valsartan in 5,010 patients with heart failure. The researchers found that the drug did indeed lower blood pressure.

"Although lowering blood pressure was a risk factor, valsartan had an effect of improving mortality and morbidity despite the reduction in blood pressure, over and above its adverse effects," Anand said.

Anand noted that the drug was particularly effective in lowering blood pressure in patients with high blood pressure. "In those who had low blood pressure it actually tended to increase the blood pressure," he said. "The drug actually had a more beneficial effect in those patients with low blood pressure."

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